American Psychiatric Association, May 5-9, 2012

The annual meeting of the American Psychiatric Association was held from May 5 to 9 in Philadelphia and attracted approximately 10,000 participants from around the world, including clinicians, academicians, allied health professionals, and others interested in psychiatry. The conference highlighted recent advances in the prevention, detection, and treatment of psychiatric conditions, with presentations focusing on mental illnesses, including post-traumatic stress disorder, Alzheimer's disease, and schizophrenia.

In one study, Abid Malik, M.D., of Orlando Health in Florida, and colleagues performed a literature review to determine whether some sleep parameters could be biological biomarkers for anxiety disorders.

"We mainly looked at rapid eye movement (REM) latency in anxiety disorders, and noted a trend for decreasing REM latency in obsessive-compulsive disorder; results from studies of panic disorder and generalized anxiety disorder were mixed," Malik said. "This review showed us some trends; however, most of the studies had small sample sizes and used different methodologies, making comparisons difficult. Now that we have more uniform scoring methods for sleep studies (polysomnography), there is a strong case for conducting more studies. We primarily focused on REM latency in this review, but in future studies, other parameters such as total time spent in REM sleep and REM fragmentation can also be assessed."

In another study, Ronit Dedesma, M.D., of the Cambridge Health Alliance in Massachusetts, and colleagues evaluated the adherence of primary care physicians and psychiatrists to monitoring metabolic syndrome parameters (as recommended by the American Psychiatric Association and American Diabetes Association) when prescribing second generation antipsychotic medication.

"We found that monitoring was suboptimal among both primary care physicians and psychiatrists. However, primary care physicians were somewhat better at monitoring blood pressure and weight. This is likely because they typically have an assistant taking blood pressure and weight measurements at the beginning of each office visit," Dedesma said. "Psychiatrists were generally better at monitoring metabolic syndrome parameters 12 weeks after treatment was started compared to at the initiation of treatment."

The investigators also implemented a program intended to help with monitoring for metabolic syndrome in these patients, which included education of providers and implementation of electronic medical record tools.

"We found that this initiative did not increase rates of monitoring. This suggests that education and computer tools alone are unlikely to facilitate significant change in our provider population. We are now looking at more systems-based changes to help increase the rates of monitoring," Dedesma added.

The investigators also found that psychiatric disorders did not affect compliance with sleep disorders treatment and that there was no significant improvement observed for specific psychiatric disorders.

"Sleep disorders and psychiatric disorders are comorbid and have a bidirectional relationship. Patients should be evaluated comprehensively and treated for sleep disorders because treatment improves overall outcomes in psychiatric disorders," Vyas added. "There is a strong need for prospective studies with more subjects."